肾脏血流阻力指数比率在评估小儿肾积水肾脏功能中的价值

Utility of resistive index ratio in evaluating the function of hydronephrotic kidney in infants and children

目的 :探讨双侧肾脏血流阻力指数比率判断小儿先天性梗阻性肾积水肾脏功能的应用价值。方法 :收集 2 9例肾积水患儿 (共 34侧积水肾脏 ,2个月～ 1 2岁 , x±s(5 .9± 4 .3)岁 ) ,按积水程度分为 4度 (组 ) ;35例正常小儿 (2 3d～ 1 2岁 , x±s(6 .1± 3 .1 )岁 ) ,分别按年龄分为 3组 (4岁以下、4至 7岁、8岁以上 )。肾积水组患儿 ,用彩色多普勒超声测量肾内叶间动脉收缩期最大血流速度 (vmax)、舒张期最小血流速度 (vmin)、阻力指数 (RI)、搏动指数(PI) ,然后计算阻力指数比率 (resistiveindexratio ,RIR =患侧肾脏RI/对侧肾脏RI)。并比较各参数在各组间的差异。结果 :积水肾脏RI明显高于正常小儿肾脏 (P <0 .0 5) ,积水对侧肾脏的RI明显低于正常小儿 (P <0 .0 5)。正常小儿的RI随年龄的增加而减小 ,有 45 .7%的正常小儿的RI>0 .7。正常肾脏的阻力指数比率 (resistiveindexratio ,RIR)与年龄无关 (P >0 .0 5)。各年龄组的肾积水患儿RIR均明显高于正常小儿 (P <0 .0 5) ,仅有 8.6 %的正常小儿RIR >1 .1 0。结论 :RIR受年龄因素的影响较小且与肾积水程度有一定相关 。

Aim:To investigate the utility of resistive index (RI) ratio in evaluating the renal function of obstructive hydronephrosis in infants and children. Method:Twenty nine infants and children with hydronephrosis and 35 normal infants and children were examined. Systolic velocity, diastolic velocity, RI,and pulsatility index of every kidney were measured by color Doppler ultrasound. RI ratio (hydronephrotic kidney RI/contralateral RI) was calculated. Results:RI for hydronephrotic and normal kidneys had significant differences. RI for 45.7% normal kidneys was higher than 0.7. RIR did not change with age.RIR for hydronephrotic kidneys and normal kidneys had significant differences. Only 8.6% normal kidneys showed abnormal RIR. Conclusion:RIR is probably more useful than RI in diagnosing obstructive hydronephrosis in infants and children.